Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (31)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Lloyd, M.E.
Right arrow Articles by Hughes, R.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lloyd, M.E.
Right arrow Articles by Hughes, R.A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Q J Med 1999; 92: 551-563
© 1999 Association of Physicians

Review

The effects of methotrexate on pregnancy, fertility and lactation

M.E. Lloyd, M. Carr1, P. Mcelhatton2, G.M. Hall1 and R.A. Hughes1

From the Department of Rheumatology, Frimley Park Hospital, Frimley, 1 Department of Rheumatology, St Peter's Hospital, Chertsey, and 2 National Teratology Information Service, Newcastle-upon-Tyne, UK

Dr M.E. Lloyd, Department of Rheumatology, Frimley Park Hospital, Portsmouth Road, Frimley, Surrey GU16 5UJ


   Introduction
 
Low-dose weekly methotrexate (MTX) is widely used in the treatment of rheumatoid arthritis1 and is now increasingly used in other rheumatic conditions, including systemic lupus erythematosus and juvenile arthritis. Because of its anti-metabolic and cytotoxic actions, questions of its safety in those of childbearing age are likely to become increasingly important. The aim of this review is to aid clinicians in the counselling and education of patients taking or about to start taking low-dose MTX. We examine the effects of MTX with respect to fertility, pregnancy and lactation, based upon information obtained using `Medline' search strategies from 1966 to 1997, hand search through the last ten years of the journal Teratology, source paper references and data from the UK National Teratology Information Service (NTIS) from 1992.


   Background
 
MTX is a derivative of the folic acid analogues. The importance of folic acid, a B group vitamin, in haematopoiesis was realized in the . . . [Full Text of this Article]


   Methotrexate in pregnancy
 
Folic acid deficiency in pregnancy
Animal studies
Human studies
Folic acid antagonists in pregnancy: animal studies
Folic acid antagonists in pregnancy: humans
The aminopterin syndrome
Methotrexate in malignant conditions
Low-dose methotrexate
Methotrexate in late pregnancy
Other cases
Methotrexate exposure before conception
Summary of evidence for methotrexate as a possible teratogen
Folic acid supplementation and methotrexate exposure
Methotrexate and abortion
Long-term effects of methotrexate treatment in pregnancy
Methotrexate and fertility
Methotrexate and breast feeding

   Conclusions
 

   References
 

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Toxicol SciHome page
W. J. Wolfgang
Exploring Protection from Methotrexate-Induced Teratogenicity in Flies
Toxicol. Sci., October 1, 2007; 99(2): 363 - 365.
[Full Text] [PDF]